{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:45:54Z","timestamp":1790390754183,"version":"4.1.0"},"reference-count":24,"publisher":"BMJ","issue":"6","funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01DA042859"],"award-info":[{"award-number":["R01DA042859"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2022,2,20]]},"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To determine the effect of prescription opioid use in the year before surgery on opioid consumption after surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Recently developed postoperative opioid prescribing guidelines rely on data from opioid-na\u00efve patients. However, opioid use in the USA is common, and the impact of prior opioid exposure on the consumption of opioids after surgery is unclear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Population-based cohort study of 26,001 adults 18 years of age and older who underwent one of nine elective general or gynecologic surgical procedures between January 1, 2017 and October 31, 2019, with prospectively collected patient-reported data from the Michigan Surgical Quality Collaborative (MSQC) linked to state prescription drug monitoring program at 70 MSQC-participating hospitals on 30-day patient-reported opioid consumption in oral morphine equivalents (OME) (primary outcome).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Compared with opioid-na\u00efve participants, opioid-exposed participants (26% of sample) consumed more prescription opioids after surgery (adjusted OME difference 12, 95%\u2009CI 10 to 14). Greater opioid exposure was associated with higher postoperative consumption in a dose-dependent manner, with chronic users reporting the greatest consumption (additional OMEs 32, 95%\u2009CI 21 to 42). However, for eight of nine procedures, 90% of opioid-exposed participants consumed \u2264150 OMEs. Among those receiving perioperative prescriptions, opioid-exposed participants had higher likelihood of refill (adjusted OR 4.7, 95% CI 4.4 to 5.1), number of refills (adjusted incidence rate ratio 4.0, 95%\u2009CI 3.7 to 4.3), and average refill amount (adjusted OME difference 333, 95%\u2009CI 292 to 374)).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Preoperative opioid use is associated with small increases in patient-reported opioid consumption after surgery for most patients, though greater differences exist for patients with chronic use. For most patients with preoperative opioid exposure, existing guidelines may meet their postoperative needs. However, guidelines may need tailoring for patients with chronic use, and providers should anticipate a higher likelihood of postoperative refills for all opioid-exposed patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rapm-2021-103388","type":"journal-article","created":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T11:06:54Z","timestamp":1646305614000},"page":"346-352","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Association of opioid exposure before surgery with opioid consumption after surgery"],"prefix":"10.1136","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9406-5953","authenticated-orcid":false,"given":"Mark C","family":"Bicket","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA"},{"name":"School of Public Health, University of Michigan, Ann Arbor, Michigan, USA"},{"name":"Opioid Prescribing Engagement Network, Institute for Healthcare Innovation and Policy, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vidhya","family":"Gunaseelan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA"},{"name":"Opioid Prescribing Engagement Network, Institute for Healthcare Innovation and Policy, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooja","family":"Lagisetty","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA"},{"name":"Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne C","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Bohnert","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA"},{"name":"School of Public Health, University of Michigan, Ann Arbor, Michigan, USA"},{"name":"Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Assenmacher","sequence":"additional","affiliation":[{"name":"Department of Surgery, Henry Ford Allegiance Health, Jackson, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melwyn","family":"Sequeira","sequence":"additional","affiliation":[{"name":"Department of Surgery, MidMichigan Medical Center, Midland, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J","family":"Englesbe","sequence":"additional","affiliation":[{"name":"Opioid Prescribing Engagement Network, Institute for Healthcare Innovation and Policy, University of Michigan, Ann Arbor, Michigan, USA"},{"name":"Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chad M","family":"Brummett","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA"},{"name":"Opioid Prescribing Engagement Network, Institute for Healthcare Innovation and Policy, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer F","family":"Waljee","sequence":"additional","affiliation":[{"name":"Opioid Prescribing Engagement Network, Institute for Healthcare Innovation and Policy, University of Michigan, Ann Arbor, Michigan, USA"},{"name":"Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,3,3]]},"reference":[{"key":"2025101111261196000_47.6.346.1","unstructured":"Ahmad F , Rossen L , Spencer M . Provisional drug overdose death counts. National center for health statistics. Natl. Cent. Heal. Stat 2020 https:\/\/www.cdc.gov\/nchs\/nvss\/vsrr\/drug-overdose-data.htm"},{"key":"2025101111261196000_47.6.346.2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002458"},{"key":"2025101111261196000_47.6.346.3","first-page":"1","article-title":"The association between preoperative opioid exposure and prolonged postoperative use","volume":"274","author":"Katzman","year":"2020","journal-title":"Ann Surg"},{"key":"2025101111261196000_47.6.346.4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13643-020-01393-8","article-title":"Leftover opioids following adult surgical procedures: a systematic review and meta-analysis","volume":"9","author":"Schirle","year":"2020","journal-title":"Syst Rev"},{"key":"2025101111261196000_47.6.346.5","doi-asserted-by":"publisher","DOI":"10.1093\/ajhp\/zxz146"},{"key":"2025101111261196000_47.6.346.6","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2020-011295"},{"key":"2025101111261196000_47.6.346.7","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1056\/NEJMc1905045","article-title":"Statewide implementation of postoperative opioid prescribing guidelines","volume":"381","author":"Vu","year":"2019","journal-title":"N Engl J Med"},{"key":"2025101111261196000_47.6.346.8","doi-asserted-by":"crossref","DOI":"10.1001\/jamasurg.2017.4436","article-title":"Reduction in opioid prescribing through evidence-based prescribing guidelines","volume":"153","author":"Howard","year":"2018","journal-title":"JAMA Surg"},{"key":"2025101111261196000_47.6.346.9","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1097\/SLA.0000000000003109","article-title":"Classifying preoperative opioid use for surgical care","volume":"271","author":"Vu","year":"2020","journal-title":"Ann Surg"},{"key":"2025101111261196000_47.6.346.10","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001901"},{"key":"2025101111261196000_47.6.346.11","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2010.220"},{"key":"2025101111261196000_47.6.346.12","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1001\/jamasurg.2017.1527","article-title":"Surgeon variation in complications with minimally invasive and open colectomy: results from the Michigan surgical quality collaborative","volume":"152","author":"Healy","year":"2017","journal-title":"JAMA Surg"},{"key":"2025101111261196000_47.6.346.13","unstructured":"Centers for Disease Control and Prevention . Cdc file of national drug codes for selected benzodiazepines, muscle relaxants, stimulants, opioid analgesics, and linked oral morphine milligram equivalent conversion factors for opioids, 2019 version, 2020. Available: https:\/\/www.cdc.gov\/drugoverdose\/resources\/data.html [Accessed 04 Dec 2020]."},{"key":"2025101111261196000_47.6.346.14","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1097\/SLA.0000000000003235","article-title":"Care coordination for patients on chronic opioid therapy following surgery: a cohort study","volume":"272","author":"Lagisetty","year":"2020","journal-title":"Ann Surg"},{"key":"2025101111261196000_47.6.346.15","doi-asserted-by":"crossref","DOI":"10.1001\/jamasurg.2018.4234","article-title":"Association of opioid prescribing with opioid consumption after surgery in Michigan","volume":"154","author":"Howard","year":"2019","journal-title":"JAMA Surg"},{"key":"2025101111261196000_47.6.346.16","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/j.jamcollsurg.2019.12.023","article-title":"Postoperative opioid prescription reduction strategy in a regional healthcare system","volume":"230","author":"Frazee","year":"2020","journal-title":"J Am Coll Surg"},{"key":"2025101111261196000_47.6.346.17","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1016\/S0140-6736(19)30428-3","article-title":"Inappropriate opioid prescription after surgery","volume":"393","author":"Neuman","year":"2019","journal-title":"Lancet"},{"key":"2025101111261196000_47.6.346.18","unstructured":"Michigan Opioid Prescribing Engagement Network . Prescribing recommendations, 2020. Available: https:\/\/michigan-open.org\/prescribing-recommendations\/"},{"key":"2025101111261196000_47.6.346.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2018.07.659"},{"key":"2025101111261196000_47.6.346.20","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002919"},{"key":"2025101111261196000_47.6.346.21","doi-asserted-by":"crossref","DOI":"10.1001\/jamasurg.2018.2666","article-title":"Association of the use of a mandatory prescription drug monitoring program with prescribing practices for patients undergoing elective surgery","volume":"153","author":"Stucke","year":"2018","journal-title":"JAMA Surg"},{"key":"2025101111261196000_47.6.346.22","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.jsat.2018.08.006","article-title":"Variations in prescription drug monitoring program use by prescriber specialty","volume":"94","author":"Sun","year":"2018","journal-title":"J Subst Abuse Treat"},{"key":"2025101111261196000_47.6.346.23","doi-asserted-by":"crossref","DOI":"10.1001\/jamasurg.2018.2102","article-title":"Prevalence of preoperative opioid use and characteristics associated with opioid use among patients presenting for surgery","volume":"153","author":"Hilliard","year":"2018","journal-title":"JAMA Surg"},{"key":"2025101111261196000_47.6.346.24","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1002\/cpt.2027","article-title":"Tolerance to opioid-induced respiratory depression in chronic high-dose opioid users: a model-based comparison with Opioid-Na\u00efve individuals","volume":"109","author":"Algera","year":"2021","journal-title":"Clin Pharmacol Ther"}],"container-title":["Regional Anesthesia &amp; Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rapm-2021-103388","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T18:26:23Z","timestamp":1760207183000},"score":1,"resource":{"primary":{"URL":"https:\/\/rapm.bmj.com\/lookup\/doi\/10.1136\/rapm-2021-103388"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,3]]},"references-count":24,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,4,21]]},"published-print":{"date-parts":[[2022,6]]}},"alternative-id":["10.1136\/rapm-2021-103388"],"URL":"https:\/\/doi.org\/10.1136\/rapm-2021-103388","relation":{},"ISSN":["1098-7339","1532-8651"],"issn-type":[{"value":"1098-7339","type":"print"},{"value":"1532-8651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,3]]}}}